Wounds are commonplace from childhood to old age. Wounds are a significant problem among the geriatric and nursing home population, especially at the end of life. Pressure ulcers alone exact a tremendous human and financial toll, costing on average more than $1,200 per patient per month to treat. The prevalence of pressure ulcers in 1997 was 16 of every 1,000 nursing home residents. A goal of a federal program, “Healthy People 2010” is a reduction of pressure ulcers to a prevalence of less than 8 per 1,000. Diabetic ulcers similarly result in significant morbidity and costs, with diabetics accounting for approximately 82,000 amputations annually in the U.S., averaging $30,000 per amputation. Other wounds plaguing the nursing home and end of life population are ulcers resulting from arterial and venous insufficiency, as well as traumatic wounds, and non-healing surgical wounds.
Most of the wounds treated are chronic wounds, often persisting for many months. Especially among the terminally ill, there is little expectation of healing a wound due to the population being malnourished, immobile and with many comorbidities that inhibit and delay wound healing. In addition, often the patient will not live long enough to heal a wound. In the terminally ill patient, the goal typically is palliation, including relief of pain, and prevention of infection. A chronic wound is any break, or ulceration, of the skin that is of long duration or recurs frequently and has not responded to conventional therapies.
Standard wound care involves debridement, cleansing and covering the wound with any of a variety of commercially available dressings. There are many special dressings available which are designed to keep wounds moist or absorb exudates. Some specialty dressings have silver impregnated in the dressing to prevent infection. Typically dressings are attached either with self-adhesive or tape, or in some cases are applied with a compression wrap. Recent high tech approaches are available for wound care using thermal wound treatments and vacuum pumps. While these can be effective, they are very expensive and healing times are still measured in weeks or months. As such, it is desired to have an inexpensive wound treatment method and composition which reduces the time required for wounds to heal.